PROJECT SUMMARY/ABSTRACT This proposal organizes the resources and experience of the Appalachian and Great Lakes Research Biospecimen Resource (AGL-RBR) for participation as an Adult Division of the NCI Cooperative Human Tissue Network (CHTN). Our AGL-RBR group of pathologists is equipped to efficiently provide remnant patient consented biospecimens for basic and early translational cancer research as well as for biomarker research studies to support personalized medicine. The Ohio State University (OSU) Hospital and James Cancer Hospital in Columbus, OH will function as the Coordinating/Procurement Center while University Hospitals Cleveland Medical Center, Cleveland, OH, University at Buffalo hospital affiliations, Buffalo, NY and University of Pittsburgh Medical Center Shadyside, Pittsburgh, PA and associated hospitals will function as geographically distributed Procurement/Biorepository sites. The OSU Coordinating Center- Investigator Management Service will manage the investigator applications and approvals and investigator biospecimen request networking. The OSU Biospecimen Management Service will handle the tissue Quality Control, biospecimen storage and shipping and CHTN fee billing, collections and monthly accounting. Tissue Procurement supports custom biospecimen collection including investigator provided novel preservation fluids or methods. Available informatics support collection of data related to donor consents, biospecimens, investigators and billing. Shipped biospecimens include a redacted Pathology and QC Report for each biospecimen shipped. Pathology Reports at OSU for freshly procured tissues include clinically appropriate molecular testing. Investigators may also request, if IRB approved, extensive clinical data available from the OSU Information Warehouse (IW) and additional laboratory testing such as immunohistochemistry, tissue microarray construction, digital microscopy or digital morphometrics. Biospecimen donor privacy and confidentiality are essential elements of the AGL-RBR biospecimen management proposal so that all procured biospecimens are patient consented and coded. Delinking is available for special tissues that were not consented at procurement. The OSU procurement program joined the OSU Comprehensive Cancer Center (OSUCCC) in deploying the Total Cancer Care (TCC) protocol in 2016 to provide comprehensive donor consent. Donors who consent give full use for future research all of their past, present and future remnant biomaterials to IRB approved researchers. Procurement/Biorepository sites have similar consent programs in place. Scientific or technical knowledge or discoveries acquired in the conduct of our tissue procurement/preservation program will be reported at national and international scientific and technical meetings to contribute to the growth of biospecimen science, to recruit new investigators who have research interests best served by human biospecimen research and to inform the research community and public.